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NPI Code Detail

MEDICARE: LAKE HARRIS HEALTH SYSTEMS LLC

MEDICARE: LAKE HARRIS HEALTH SYSTEMS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency299991027FL

General Provider Information

NPI Number : 1407050578
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE HARRIS HEALTH SYSTEMS LLC
Provider Business Mailing Address
First Line : 701 LAKE PORT BLVD
Second Line :
City : LEESBURG
State : FL
Zip : 34748-7674
Country : US
Telephone Number : 352-728-3366
Fax Number : 352-728-6158
Provider Business Practice Location Address
First Line : 701 LAKE PORT BLVD
Second Line :
City : LEESBURG
State : FL
Zip : 34748-7674
Country : US
Telephone Number : 352-728-3366
Fax Number : 352-728-6158
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. SANDRA I MITCHELL
Credential :
Telephone Number : 352-728-3366
Provider Enumeration Date : 06/13/2007
Last Update Date : 01/30/2012

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Directions to “LAKE HARRIS HEALTH SYSTEMS LLC ” Practice Location

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